Pharma supply chain ramps up technology to battle opioid epidemic

Until recently, pharmacists relied on their intuition and network of other pharmacists they would call if a suspicious prescription surfaced. Today, nearly all prescription pads are tamper-proof, if physicians haven’t already transitioned to electronic prescribing. More Cincinnati doctors are using e-prescribing, said Hart, who lauded the trend. And more states are also using interstate communication systems that track the types of prescriptions and where they are filled.

The Ohio Automated Rx Reporting System is one of the statewide databases that collect real-time information on controlled substances sold to pharmacies, including when and where they are dispensed. The statewide databases feed into an interoperable communication system called PMP Interconnect that connects pharmacists throughout the country to track usage, prescribing and dispensing patterns. The prescription monitoring program, headed by the National Association of Boards of Pharmacy, was started in 2011 and is online in 42 states, with more in the queue.

Providers in 27 states have also integrated PMP Gateway into their EHR systems, bringing prescription-usage and -filling trends to their fingertips. It alerts physicians when a patient has received several opioid prescriptions over a short period of time, among other behaviors.

These types of systems are vital in curbing the number of counterfeit prescriptions, advocates argue. Some 33,000 illegal online pharmacies are operating at any given time, driven by attractive profit margins and fragmented regulations, according to the Alliance for Safe Online Pharmacies. A new push for “.pharmacy” domains has helped patients identify legitimate sources for online drugs, said Libby Baney, ASOP’s executive director.

Arming providers, pharmacists and law enforcement with interoperable data is crucial and those throughout the industry should be encouraged or even compelled to buy in, Baney said.

“Policy and enforcement have not kept pace with the consolidation of the supply chain and distribution of medicines, particularly with online sales,” she said. “We need to harmonize domestic and international regulations and increase transparency.”

But the databases are not a panacea, critics warn, and much more needs to be done to improve coordination among regulators and those in the drug supply chain.

Under the recently implemented Drug Supply Chain Security Act, manufacturers will need to create individual serial numbers for every prescription, which ideally would help determine where the drugs came from and how they got to the patient.

“We will start to get a lot more visibility in not only the flow of these drugs but understand who held them and where they traveled along the supply chain, said Paul Cianciolo, who heads health systems development for TraceLink, a company that provides a digital track-and-trace network for the pharmaceutical supply chain.